New, and I have a problem

In the fall of 2015 I was suddenly unemployed, and learned that two acquaintances had had WLS. I asked for a referral and started going to their surgeon, Dr. Julie Ellner in San Diego, CA. She came strongly recommended and very trusted, with an extensive background and decades of experience. I went to her for 4 months, during which time I couldn't get a handle on the diet but did have some testing done. One of those tests was an endoscopy.

I started working on Pendleton Marine Corps base, 40 miles from home (and I still work there). Since I was new, didn't have any PTO yet, would have had to take a half day off to get to the office, and hadn't been mentally prepared for the program anyway, I emailed her receptionist and told her I wanted to cancel my next appointment where I would get the results of the endoscopy and would not be maintaining my status as their patient. Dawn told me that was fine, Dr. Ellner had found "mild irritation" in my esophagus, take this prescription which had one refill and it would be fine. So I did.

I got settled at work, saved some PTO, and emailed Dawn to come back and try the program again (now a year+ later). I've been going for two months and so far I'm down 16 pounds. All is well there. BUT.

At my first appointment Dr. Ellner asked me why I wasn't still taking the omeprazole. I said, "well, I did...I finished it..." and she looked alarmed. Then she said, "oh no, you need to take that for life, you have Barrett's Syndrome, I found precancerous cells!"

Whu-WHAT?? Shouldn't I have been contacted about this FOURTEEN MONTHS AGO?

it turns out that I cancelled my appointment and my patient status (through Dawn) before they got the biopsy results from the lab. When those came in with Barrett's Syndrome and precancerous cells they faxed them to my PCP. My PCP never contacted me.

Dr. Ellner immediately put me back on omeprazole and scheduled another endoscopy with another provider for the next week. I had that done with Dr. Reddy in San Diego, and the next week he told me...

...everything is fine. No Barrett's Syndrome, no precancerous cells, a couple of benign polyps, see you in 5 years.

What? I mean, YAY, but what? How is this possible? Isn't Barrett's irreversible?

Now the problem is that my husband is LIVID and doesn't trust Dr. Ellner, at all. He is furious that they didn't contact me directly when they got the initial lab results, even though I was no longer their patient and for all they knew would never be back. He wants to know what happened--"are they incompetent and did the wrong test and don't know how to read the results, or is Dr. Reddy wrong and you possibly still have pre-cancerous cells in your throat??" He also says, "if they can't do this, then I don't want them taking a SCALPEL to you!" I've tried to tell him that Dr. Ellner is very highly regarded and has a great reputation for being exacting, demanding with her hospital support staff, and meticulous with her patient care, but he's not convinced.

So the question is...what do I do here? How do I move forward? I like Dr. Ellner and I'd like to have my surgery (RNY) done by her. Am I being foolish? Am I blinded by the fact that I like her as a person? Was the initial slip with the test results unforgivable? Is Barrett's reversible? Should I get a third opinion? I'd appreciate any advice from people with more experience.

Anyone can make a mistake.I'm just glad you don't have Barrett's.You are the one who has to trust the DR.You husband can be afraid of the surgery,but he is trying to be supportive.A lot of people,spouses and significant other have fears when it comes to this surgery.That being said there no replacement for a very experienced Dr. Trust your instinct .

I had the sleeve in 2011.then had revision to bypass, in Nov 2016 due to severe acid reflux. My same Dr. did both surgeries.I trusted him to do a great job and he did.

Hope this helps.

One lab test was incorrect. You may or may not have Barrett's.

Get a third opinion and find a different weight loss surgeon. Your husband will never have confidence in Dr. Ellner and you need his support.

It's worth having a repeat endoscopy to check for Barrett's.

Only you can say if you are comfortable continuing with this surgeon. Your husband can express his concern, but the choice is not his.

I would want a third test/opinion.

You have one test that says what you want -- but another that needs addressed if that one is wrong. I would want a third opinion here to verify that you do not currently have GERD/Barretts -- and what preventative medication you should continue taking. I believe that Dr. Ellner was correct that you should be on a proton-pump inhibitor for life.

I think it's your PCP who failed you.

In my experience, BE can be resolved. My FIL was diagnosed with BE in 2013 and was diagnosed as "resolved" in 2014. The GI doctors (3 of them!) explained that if during the endoscopy and biopsy the lining intestinal lining which is a deeper red, it is called intestinal metaplasia. Intestinal metaplasia has been associated with the development of esophageal adnocarcinoma (cancer) of the lower esophagus. For all practical purposes, Barrett's esophagus and Barrett's epithelium are the same thing.

My FIL has to go every 2 years for another biopsy to verify that there has been no evolution towards malignant change of the mucosa. He is also on achiphex which he must take for life, coupled with an anti GERD diet. All three specialists explained to him that once you've had it, cells were exposed and they could go back to precancerous condition as he will always be prone to it.

After this, my best friend had a very similar experience in 2014. She was put on Omeprazole and was later told the BE had resolved. Sadly, she recently went in for her testing again (February) and was told that it was back and had to have several cancerous cells removed. She had absolutely no symptoms. Had she not gone in for her check, she may have missed it completely until it was too late.

Therefore, it is quite possible that both doctors were correct.

Ok, first of all, the erosion caused by GERD's CAN be considered pre-cancerous because there is data showing that it CAN lead to cancer. Not a huge deal as a lot of things are pre-cancerous. I have a ton of actinic keratosis as do most people. Those also are pre cancerous but most of us do nothing about them as they are very common.

You left your surgeon's practice, the surgeon probably felt your PCP was handling your care at that point. I don't think its quite fair to put the blame there. After all, WE are the one's who should stay informed and be an active participant in our health care.

Anyway, what's done is in the past, what you need to decide from here on is what is the best course for you to take at this juncture in your life!

I wish you all the best on your journey :)

Ceci

I have never replied to a post on here and have been a member since 2007. I had RNY at Balboa Hospital in 2012. My mother had RNY by Dr Ellner in 2008. She is a wonderful and very will respected doctor. I would get one more opinion. My dad died from esophageal cancer because he was never checked and had Barretts Syndrome that turned into cancer. Please be very careful and have it checked out. I still live in San Diego so if you need someone to chat with I am here.